| National Provider Identifier [NPI]: | 1942568811 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | ASHLEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1365 W BRIERBROOK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 381382208 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 835 |
| Number Of Medicare Beneficiaries | 25 |
| Total Submitted Charge Amount | 25991 |
| Total Medicare Allowed Amount | 20118.32 |
| Total Medicare Payment Amount | 14454.04 |
| Total Medicare Standardized Payment Amount | 19041.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 357 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2283 |
| Total Drug Medicare AllowedAmount | 1733.24 |
| Total Drug Medicare PaymentAmount | 1268.41 |
| Total Drug Medicare Standardized Payment Amount | 1268.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 478 |
| Number Of Medicare Beneficiaries With Medical Services | 25 |
| Total Medical Submitted Charge Amount | 23708 |
| Total Medical Medicare Allowed Amount | 18385.08 |
| Total Medical Medicare Payment Amount | 13185.63 |
| Total Medical Medicare Standardized Payment Amount | 17772.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 0 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 25 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7932 |